Medicine and Health Sciences Commons^™

The Arv Treatment Adherence Model: A Qualitative Study On Antiretroviral (Arv) Treatment Adherence For People Living With Hiv, Danielle Strauss

Dissertations, Theses, and Capstone Projects

Adherence to antiretroviral (ARV) treatment improves life expectancy and other health outcomes for people living with HIV (PLWH). It also minimizes their risk of transmitting HIV through sexual contact and is therefore a form of HIV prevention. However, many PLWH, specifically low-income PLWH of color who have been disproportionately impacted by the virus, face a multitude of barriers to ARV treatment adherence, making it much harder for them to take their medication as prescribed and remain engaged in care. This qualitative study based on Constructivist Grounded Theory explored the process by which 14 virally suppressed, low-income PLWH of color overcame …

Exploring Social Identity Threat And Safety Cues For Lesbian, Gay, Bisexual, Pansexual, And Queer Cisgender Women In Ob/Gyn Care, Rachel Fikslin

Dissertations, Theses, and Capstone Projects

Lesbian, gay, bisexual, pansexual and queer (LGBPQ) cisgender women (CW) experience a number of health inequities compared to heterosexual cisgender women related to sexual and reproductive health. Heterosexist health care cultures may signal social identity threat for LGBPQ-CW that may undermine their health care engagement and outcomes. In three online studies, I examined the effects of two heterosexist cultures (i.e., gender essentialism and pronatalism) as well as two potentially identity-safe alternatives (i.e., gender diversity and reproductive/sexual autonomy) on the identity threat and health care engagement experiences of LGBPQ-CW in OB/GYN care.

In Study 1 (n = 213), I used …

Neurocardiovascular Instability (Ncvi) Risk As A Predictor Of Cognitive Function In The Long Life Family Study, Rebecca Abraham

Dissertations, Theses, and Capstone Projects

In aging populations, the abnormal neural control of the cardiovascular system has been examined within the construct of neurocardiovascular instability (NCVI). The main research aim addressed whether baseline features of NCVI could predict cognitive function (i.e., decline) at follow-up within long-lived families. Across 941 subjects, baseline NCVI risk was indexed by two features: (1) self-reported syncopal or fall events and (2) average seated BP. The Low NCVI risk group included those who were normotensive (e.g., within normal BP range) and reported no NCVI features (n=379). The Moderate NCVI risk group included those who elicited pre-hypertensive (elevated BP) or hypertensive (high …

Lactating Justice: Constructing A Society Economically Focused On Optimizing Health Through Human Lactation, Shadley Hobour

Dissertations, Theses, and Capstone Projects

This paper uses a qualitative research method to answer if a Universal Base Income would be a good economic policy to adopt to optimize Black chestfeeding. The key idea this thesis aims to clarify is how anti Blackness is killing Black people and how one economic policy could improve health. In this essay, I will break down the significance and importance of human lactation for lifelong better health, and investment in a UBI would especially work as a preventative measure for several health issues Black people experiences.

Reflecting On Resilience: Insight Into Resiliency Development And Utilization In Oregon's Older Adults From 2020 To 2022, Riley A. Wilton

University Honors Theses

The events of the last 2 years have complicated the lives of older adults throughout the world. For many, their survival can be traced back to one key trait: resilience. In the state of Oregon, the years 2020-2022 came with a host of issues that expanded past the COVID-19 pandemic. These events provide context for the world our storytellers discuss.

Using a snowball recruitment strategy through the efforts of community organizations and senior centers, 4 storytellers sat down to describe their resilience in different ways. They were asked to reflect on their own life experiences, how it influenced their resilience, …

Augmentative And Alternative Communication Use, Service Delivery Experiences, And Communicative Participation For People With Amyotrophic Lateral Sclerosis, Betts Peters

Dissertations and Theses

People with amyotrophic lateral sclerosis (ALS) often experience changes to their speech, and may use augmentative and alternative communication (AAC) devices and techniques to maintain the ability to communicate. The use of AAC may facilitate the participation of people with ALS in various life situations involving communication. There is limited data in the literature about the AAC approaches currently used by people with ALS, the professional services they receive to support communication, or the effects of AAC on their communicative participation. This dissertation involved a nationwide online survey of people with ALS, and comprises three papers intended to add to …

Episode Based Payment Models And The Hospital Safety-Net: An Evaluation Of The Center For Medicare And Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program, John A. Gravina

Dissertations and Theses

Episode Based Payment Models and the Hospital Safety-net: An Evaluation of the Center for Medicare and Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program

By John Anthony Gravina

Advisor: Alexis Pozen, Ph.D.

Introduction: Payments for Healthcare services are increasingly being tied to clinical quality, patient experience, health outcomes, and efficiency through value-based payment arrangements (VBP). VBP presents a potential opportunity to reduce healthcare expenditures by requiring providers to take on financial risk associated with the cost and quality of care, therefore aligning payment incentives with the goals of providing higher quality and efficient care. As of 2020, 80 percent of …

Combined Treatment Model Program For Survivors Of Intimate Partner Violence, Hillary Jeanne May

Loma Linda University Electronic Theses, Dissertations & Projects

This project seeks to fill a void in the mental health field by providing a combined treatment model program to address the needs of survivors of intimate partner violence. As such, the primary purpose of this project is the development of a treatment program with services that are easily accessible by survivors that is intended for future implementation in shelters or agencies that have contact with this population of women. This program offers a means to engage an underserved population in access to services and self-development to improve overall mental and physical health outcomes and attempt to prevent recurrent intimate …

Decolonizing Psychotherapy, Nicole D. Taylor

Loma Linda University Electronic Theses, Dissertations & Projects

This project aims to increase the use and inclusivity of mental health services within marginalized communities by providing education and training tools on the use and application of integrative mental health approaches. It is an offering of guidance, providing a culturally responsive framework for integrating yoga into psychotherapy. The manual aims to reduce systemic, colonialist, barriers to mental health services. This project is founded on the basis that mono-cultural foundations in traditional psychotherapeutic treatments negatively impact the attitudes and beliefs of service seekers, typically within excluded groups. Systems Theory and Critical Race Theory and Social Justice principles inform the application …

Elisa Validation Method For The Detection Of Ketamine In Hair, Daria A. Centonza

Student Theses

An ELISA method was developed and validated to detect ketamine in human hair samples. Ketamine is an anesthetic drug that causes memory loss, dissociative sensations, and hallucinations. Due to these adverse effects, ketamine is a common drug used in drug facilitated sexual assaults (DFSAs). It is very important to be able to detect the substances used in DFSAs over a longer period of time due to the delayed reporting of these crimes. Victims, often out of fear and from the sedative/memory loss effects of the drugs, tend to report these crimes when it is too late to use urine and …

Associations Between Concepts Of The Family Management Style Framework, And Measures Of Child Adherence To Treatment For Heterozygous Familial Hypercholesterolemia, Heather Harker Ryan

Graduate Doctoral Dissertations

Background: Heterozygous Familial Hypercholesterolemia (HeFH) is an underdiagnosed, autosomal dominant, monogenic condition affecting ~1:250 individuals in the United States (U.S.), resulting in cardiovascular events 10-20 years earlier than in unaffected peers.

Sample: Fifty-one parents of youth aged 2-18 years followed for HeFH in a pediatric specialty clinic.

Purpose: Assess parental perceptions of HeFH, child adherence to treatment, and parenting in HeFH-affected households.

Methods: A cross-sectional, descriptive, and correlational survey study congruent with elements of the Family Management Style Framework (FMSF). Pearson’s and Spearman’s correlations assessed linear relationships between parentally observed HeFH treatment adherence measures, parenting style, and parental perceptions of …

The Role Of Physical Activity And Gender As Moderators For The Relationship Between Insomnia And Depression, Claire E. Wickersham

Graduate Doctoral Dissertations

Objective: The aim of this study was to examine the association between insomnia and depressive symptoms among middle-aged and older adults and to investigate whether gender or physical activity moderates this relationship. Method: This study used nationally representative data from the 2016 and 2018 waves of the Health and Retirement Study (HRS) and binomial logistic regression was used to estimate models. Regression models for risk of depressive symptoms (2018) were based on a longitudinal model with time-lagged indicators of insomnia, levels of physical activity, and covariates (2016). Results: Analyses showed that participants who reported having insomnia in 2016 were more …

On The Roles Of Trait Anxiety And Toll Like Receptor 4 In Amphetamine Sensitization In Adolescent Male Rats, Corey A. Calhoun

Graduate Doctoral Dissertations

Mammalian adolescence can be a difficult transition from childhood to adulthood, where increases in impulsivity and novelty- and risk-seeking are combined with heightened affect and elevated sensitivity to stress. Indeed, during adolescence, first drug use patterns emerge and in the continental United States, increasing misuse of amphetamines has been observed in adolescent youth. Myriad neural mechanisms underlie this shift in adolescence, including the dynamic remodeling of the mesocorticolimbic (MCL) pathway. Repeated drug administration affects neuroimmune substrates within the MCL circuit including toll-like receptor 4 (TLR4)Advances in addiction neuroscience indicate that drugs of abuse activate neural TLR4 and implicate glial TLR4 …

Increasing Mental Health Literacy In The Black Church, Jonathan Allotey

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this project was to increase mental health literacy, assess stigmatizing attitudes, and increase help seeking behavior in leadership within an African American church.

Background: The Black church has historically been a central institution for community support and leadership within these churches are often ill equipped to address the mental health needs of congregants. African Americans underutilize mental health services and are reported to have more chronic mental illnesses. Lack of mental health literacy may result in difficulty recognizing the risk factors, signs, symptoms, and treatments related to specific mental illnesses.

Evidence Based Intervention and Methods: Participating …

Effects Of Telephone Follow-Up On Medication Adherence And Rapid Readmission Among Discharged Adults With Schizophrenia Spectrum Disorders (Ssds), Romilynn Danko, Madalyn Cosensci

Doctor of Nursing Practice Final Manuscripts

High rates of 30-day readmission after acute care discharge are a big concern for patients with psychiatric disorders. These high rates not only reflect poor patient outcomes, but also result in higher hospital costs. For adults with schizophrenia spectrum disorders (SSDs), a review of current research shows that non-adherence to medication has been significantly associated with rapid readmissions and that using an intervention such as follow-up telephone calls after discharge can help prevent readmission through increased medication adherence. Using the Iowa model framework as a guide, the purpose of this evidence-based practice project was to pilot a post discharge procedure …

A Qualitative Study On Nurse Facilitators Of Mind-Body Skills Groups, Paula D. Blake-Beckford

Mindfulness Studies Theses

The Center for Mind-Body Medicine (CMBM), founded by Dr. James Gordon, provides communities with evidence-based Mind-Body Skills Groups (MBSGs) that foster self-care, self-awareness, and self-expression. MBSGs range from 8 to 12-week series on various mind-body practices wherein group members meet, practice, and reflect on the impact of mind-body skills in their lives. Research has demonstrated that participants in MBSGs have positive outcomes. Healthcare professionals (HCPs), especially nurses, gain resiliency from MBSGs. As facilitators of MBSGs, nurses develop essential skills transferable to clinical and educational settings. MBSGs are therapeutic for adult participants with chronic stress. Prior to this thesis, only one …

Early Integration Of Palliative Care With Curative Oncology Treatment For Patients With Advanced Cancer: Implications For Clinical Nursing Practice, Rhea Rughani

Honors Projects

Palliative care, though clinically established to improve health-related quality of life measures for patients with advanced illness, remains underutilized and largely limited to end of life care. This project aims to inform oncology nursing practice through the analysis of literature supporting the early integration of palliative care with standard curative oncology treatment for patients with clinically advanced cancer. Informed by relevant research, clinical practice guidelines, and improved specialty palliative care training, oncology nurses and nurse practitioners are ideally situated to advocate for and initiate early palliative care integration, to holistically improve the standard approach to complex cancer care.

Using Machine Learning To Analyze Children’S Drawings As Indicators Of Mental Well-Being, Nicholas R. Lawrie

Master's Theses

Human figure drawings are a well-studied diagnostic tool for emotional distress in children. Cleft lip/palate is one of the most common birth defects in the world, and has been shown to negatively impact emotional well-being in childhood which can have negative economic consequences in adulthood. Utilizing a dataset of human figure drawings from children in India and survey data on mental health, this paper will assess the impact of corrective surgery on mental health outcomes, as well as assess the validity of the drawing emotional indicators themselves. The results indicate that while the emotional indicators may not be valid in …

Where I’M From: Internal Manifestations Among Cambodian Women Using The Expressive Arts A Literature Review, Noeun Chhim

Expressive Therapies Capstone Theses

Chronic mental illness has affected many Cambodian people, but, culturally, Cambodians aren’t accustomed to opening up and discussing their feelings, rather defining mental illness to craziness and seeking help is presumed taboo. Thus, Cambodians are often reluctant to talk about their experiences and/or their related illnesses. Though Cambodians have experienced inconceivable suffering and violence during the Khmer Rouge era, for the purpose of this thesis, I will be discussing the role of Cambodian women and investigate the extent of what they’ve witnessed and experienced. Cambodian women have suffered through many years of trauma and grief, during and after the Khmer …

The Neurobiology Of The Healing Arts: Expressive Arts Therapy As An Effective Treatment For Adults Diagnosed With Complex Ptsd Due To Complex Trauma In Childhood: A Literature Review, Cheryl Ratliff

Expressive Therapies Capstone Theses

Empirically based therapies for posttraumatic stress disorder (PTSD) have been found to be less effective in treating more severe trauma presentations such as complex PTSD (CPTSD). Neurobiological investigation provides a framework for examining the physical and psychological effects of trauma on brain and nerve structures and provides insight into how to effectively treat CPTSD. This literature review examined symptomology of CPTSD resulting from complex trauma in childhood, neurobiological effects of trauma and their implications for treatment, and the efficacy of the current treatment models, primarily those of eye movement desensitization and reprocessing (EMDR), narrative exposure therapy (NET), and somatic psychotherapies. …

Drama Therapy Interventions That Support Students With Asd During Covid-19, Olivia Reyes

Expressive Therapies Capstone Theses

Due to the coronavirus (COVID-19) pandemic that began in December 2019, many people experienced traumatic losses, environmental stressors, and overall daily challenges. One of the populations most at risk during this time were those with an autism spectrum disorder (ASD). Those with mental health illness and developmental differences are experiencing the pandemic in different ways. Individuals with ASD tend to have both developmental differences and mental health challenges that motivate individuals to seek medicinal and therapeutic help, along with other services to support their daily needs. This literature review addresses the negative and positive impacts COVID-19 has had on the …

Toward Holistic Mental Wellness: A Literature Review Of Mindfulness-Based And Focusing-Oriented Art Therapies, Lesley Vernon

Expressive Therapies Capstone Theses

Modern day living, for all its benefits, is synonymous with record levels of stress. The mental health clinician’s role is to assist clients in accessing the skills and tools necessary to reduce and alleviate the symptoms of stress-induced anxiety. Mindfulness is emerging as a potent and effective tool to restore one’s state of well-being. Likewise, engaging in art therapy has been shown to reduce stress and foster resilience. Grounded in humanistic and existential theories, this literature review aimed to assess the impact and effectiveness of two intermodal holistic therapies, specifically mindfulness-based art therapy (MBAT) and focusing-oriented art therapy (FOAT). A …

Finding A Middle Path: Using Expressive Arts Therapy To Engage Adolescents In Dialectical Behavior Therapy: A Literature Review, Rebecca Miller

Expressive Therapies Capstone Theses

This critical literature review explores the limited research on integrating expressive arts therapy (ExTH) with dialectical behavior therapy (DBT). DBT, an evidence-based, third-wave cognitive-behavioral intervention, has been adapted for use with adolescents struggling with emotional and behavioral dysregulation. Yet, the didactic and almost rigid nature of DBT can feel more like a school lesson and less like therapy, making it difficult for adolescents to engage with the treatment. This is problematic as DBT's effectiveness requires the client to be fully committed and willing to engage in the therapy. This paper explores the literature on combining ExTH with DBT and conceptual …

Accessing The Ecosphere: An Indoor Nature-Based Community Expressive Arts Therapy (Exat) Exploration Project, Heather Powers

Expressive Therapies Capstone Theses

This capstone thesis posits that when humans connect and maintain a relationship with nature, their mental health improves. Humans have developed from and within Earth’s ecosystem, making our relationship with nature a necessary acknowledgement that the self is more than a corporeal body but is, in fact, embedded within the natural world around us. The current overwhelming dependence on electronic advancements and the development of urban areas have led people to become more distant in their relationship to nature, putting the overall well-being of the planet in jeopardy. This thesis points out that the more separation we feel from nature, …

A Group Music Therapy Method To Promote Mentalization Skills In Clients With Narcissistic Personality Disorder, Lisa Riggs Hobbs

Expressive Therapies Capstone Theses

Abstract

This paper investigates the development of a group music therapy method by adapting elements of mentalization-based treatment (MBT) to help clients with narcissistic personality disorder (NPD). A prominent characteristic of NPD is a deficiency in empathy. The fostering of empathy and emotional awareness forms the basis of MBT. Music therapy offers a means to explore these skills on a nonverbal level. This work is even more impactful in a group setting. Unfortunately, there is a dearth of literature specific to music therapy and NPD. Furthermore, despite the availability of writings separately concerning NPD, MBT, group therapy, and music therapy, …

How Clay In Group Art Therapy Helps Female Veterans Maintain Well-Being: Development Of Methods, Sooho Park

Expressive Therapies Capstone Theses

Using clay in art therapy has emerged as an evidence-based therapeutic approach to enable treatment for people with anxiety. While clay in art therapy has been researched and proven to be highly effective with children, there is limited research on the benefit for the population of female veterans. Therefore, this study examines the possibility of how clay in art therapy helps female veterans to reduce anxiety and maintain their well-being at Veterans Affairs Hospital (VAH). Three female veterans were engaged in weekly intervention for six weeks through both in-person and online sessions. Results indicate participants experienced beneficial changes in anxiety …

Using Animal As Metaphor In Drama Therapy With Psychiatric Patients In An Intensive Outpatient Program Group Therapy Session: An Intervention, Juliana Fort

Expressive Therapies Capstone Theses

Abstract

Drama therapy may be uniquely suited to help people with mental illness who have negative beliefs about what it means to be mentally ill. It focuses on helping the individual expand their sense of what a person with mental illness can be, as well as their awareness of the other roles they may play in their lives. In the current study, the author developed a drama therapy intervention for psychiatric patients in an intensive outpatient program (IOP). The intervention uses pre-made cards that depict images of various animals. During the intervention, the participants were asked to discuss how they …

Touch In Drama Therapy: A Literature Review, Sara Hood

Expressive Therapies Capstone Theses

This article is a cursory look at how touch is perceived in the field of drama therapy. Touch is integral to our experience as humans and can be present in drama therapy sessions. Ethical guidelines for touch in the literature are identified and relevant drama therapy texts and articles describing touch are discussed. While drama therapy has a clear voice when it comes to ethically engaging in touch with a client, very little research was found exploring the intention and outcome of touch in a drama therapy session. Other therapeutic modalities, specifically Developmental Transformations and dance/movement therapy, are identified as …

Building Character By Building Characters: A Literature Review Examining The Efficacy Of Tabletop Roleplay As A Creative Intervention For Developing Social Skills In Adolescents, Kathleen Angela L. Bautista

Expressive Therapies Capstone Theses

In the realm of tabletop roleplay games, Dungeons & Dragons (D&D) earned a reputation as the most prolific franchise within the genre and has since prevailed as a popular bonding activity for peer groups of all ages and backgrounds. Among the player base in the D&D community are those that gleaned its potential to offer a conducive space for personal growth, particularly in the realm of psychosocial development, given that D&D sessions facilitated dynamic social interactions among the members. The emphasis on imagination in D&D nurtures the tenets of intermodal expression, as players are encouraged to explore their creativity through …

Using Expressive Arts Therapies To Aid The End-Of-Life Transition For Older Adults: A Literature Review, Rosemary Lape

Expressive Therapies Capstone Theses

This literature review presents the use of expressive arts therapies as they may be applied to end-of-life care for older adults. Death is inevitable and if given the chance to prepare, the expressive arts modalities provide a foundation to process the emotions associated with the ending of a life on earth. Expressive arts provide the opportunity to communicate in non-traditional ways which have the ability to locate subconscious themes. End-of-life care previously revolved around pain management. In more recent years it has evolved to caring for the whole person emotionally, socially, psychologically, and physically. Sources were found utilizing resources provided …